Breast Cancer

Breast cancer :

Description:

Breast cancer is a malignant (cancerous) growth that begins in the tissues of the breast. Cancer is a disease in which abnormal cells grow in an uncontrolled way. Breast cancer is the most common cancer in women, but it can also appear in men. In the U.S., it affects one in eight women.

The most common types of breast cancer are:

1. Ductal Carcinoma (85-90% of all cases): Also called as Ductal Carcinoma in Situ, this is a condition where ductal cancer cells grow only inside the ducts of the breast. It is often referred to as a precancerous condition. It means the abnormal cells are contained in one place (not spread into other tissue.).

2. Lobular Carcinoma: Also called as Lobular Carcinoma in Situ, the hollow glands or lobules where milk accumulates in the breast sometimes fill with abnormal (“atypical”) cells. This is a precancerous condition and does not directly lead to breast cancer. However, women who have LCIS (Lobular Carcinoma in Situ) stand a greater than average risk of developing breast cancer at some point in their lives.

The less common are:

1. Inflammatory breast cancer (IBC): IBC is a type of breast cancer which is less common than ductal or lobular breast cancer. It is an advanced, aggressive form of cancer, which is usually not detected by a mammogram or an ultrasound. When properly diagnosed, it is usually already at Stage 3b or Stage 4. It commonly grows in nests or sheets, not in lumps. This makes it easy for the cancer to spread through the body, beyond the breast, via the lymph system.

2. Paget’s disease of the nipple: Paget’s disease of the nipple or breast is a rare type of breast cancer, which can occur in women and men. It shows up in and around the nipple, and usually signals the presence of breast cancer beneath the skin. Most cases are found in menopausal women, but can also appear in women that are as young as 20.

Symptoms:

A woman suffering from breast cancer will face different symptoms. However, in case of mild cancer, often a woman will not be aware of the symptoms. However, the main symptom of breast cancer involves a change in the texture and the look of the breast. Another symptom of breast cancer is the formation of lumps in the breast or the thickening of the breast’s tissues. Another symptom of breast cancer is discharge of fluid from the breast. Another symptom of breast cancer is the tethering of the breast’s skin, as if the skin of the breast is being pulled from inside. However, the most important symptom of breast cancer is the occurrence of pain or sensation in the breast.

Treatment:

There is no easy and quick treatment for breast cancer. Doctors suggest prolonged course of treatment for this disease. The doctors often combine different methods of treatment to get the most effective results. There are different treatments of breast cancers like chemotherapy, surgery, radiotherapy or hormonal therapy. However, the doctors choose a particular type of treatment depending upon a number of factors.

The doctors will start a particular treatment after ensuring the stage and condition of the tumor. Besides, they will also find if there is any existence of any secondary tumors. Besides, they will also check the receptor status of the cancer. The doctors will also ensure the health of the patient before starting a treatment. Besides, before starting the treatment the doctor will also check the menopausal status of the patient.

The doctors may use different methods to treat a woman suffering from breast cancer. Sometimes doctors may use surgery to remove the tumor. Often doctors use chemotherapy along with surgery to make the treatment more effective. However, breast tumors can also be cured by using radio therapy or hormonal therapy. However, the doctors will choose that method of treatment that he considers best for this patient.

Causes and risk factors:

Breast cancer risk is higher among women whose close blood relatives have this disease.

Having one first-degree relative (mother, sister, or daughter) with breast cancer approximately doubles a woman’s risk. Having 2 first-degree relatives increases her risk about 5-fold.

Although the exact risk is not known, women with a family history of breast cancer in a father or brother also have an increased risk of breast cancer. Altogether, about 20% to 30% of women with breast cancer have a family member with this disease. (It’s important to note this means that 70% to 80% of women who get breast cancer do not have a family history of this disease.

Women with denser breast tissue (as seen on a mammogram) have more glandular tissue and less fatty tissue, and have a higher risk of breast cancer. Unfortunately, dense breast tissue can also make it harder for doctors to spot problems on mammograms.

Diagnosis:

Breast cancer isn’t always detected with the naked eye. Its early signs are often hidden within your breast tissues. Changes to your breasts that you do see may not be the result of breast cancer at all. Lumps and bumps may come and go, as your hormones ebb and flow, and as you age. Breast skin may change texture due to sunburn, radiation treatments, or infections that cause rashes. So how would you know for sure whether or not a lump, skin rash, or skin dimpling is benign or cancerous? You will need help from your medical professionals to get a clear diagnosis.

1. Clinical Breast Exam (CBE): Women who are between 20 and 30 years old should have a clinical breast exam during their annual physical. If irregularities are found, a mammogram and ultrasound can help clarify the nature of the problem.

Mammograms:

A mammogram is the gold standard for breast cancer screening and early detection. The American Cancer Society recommends that women 40 years old and up have an annual mammogram, though some other medical associations push that recommendation to age 50. Mammograms can help detect 85 to 90 percent of all breast cancers, even before you can feel a lump.

Breast Magnetic Resonance Imaging (MRI):

A breast MRI reveals different details of your breast health than a mammogram, so it can be used as a complementary test. MRIs don’t use compression, like mammograms, but are much more expensive and not as widely available.

Elastography:

Elastography is a new, though still investigational, technology for imaging breast tissue. It may be better than mammography, ultrasound, and MRI at distinguishing between benign and cancerous growths. Elastograms can find a cancerous lump without a biopsy.

2. Fluid Tests:

Ductal Lavage: A tiny tube is inserted into the breast to draw fluid from the breast ducts, which is then examined under a microscope or screened for cancer cells. This is also an investigational screening technique.

Aspiration: During an aspiration, your doctor will use a fine needle to suction a sample of fluid from a lump, such as a cyst, to be screened.

3. Tissue Tests:

Breast Biopsy: A surgeon can remove a very small tissue sample from your breast. The tissue will be tested and examined under a microscope for cancer.

Once all the test results are in, your doctor will summarize the diagnosis for you. Your cancer will be ranked in stages, once by your oncologist, and again by your radiologist. Knowing the stage of your breast cancer is critical to deciding on a course of treatment.

Medicine and medications:

Tamoxifen or an aromatase inhibitor is recommended for estrogen receptor-positive (ER+) breast cancer. These medicines stop estrogen from fueling ER+ breast cancer. (Only tamoxifen is used before menopause. Aromatase inhibitors seem to be more effective than tamoxifen after menopause.)

Trastuzumab (Herceptin) is recommended after surgery and chemotherapy for HER-2/neu breast cancer. This medicine targets the HER-2 protein. It helps chemotherapy work better.

A combination of medicines is generally used to treat breast cancer. The most commonly used combinations are:

AC, which combines the medicines Adriamycin and Cytoxan. Taxol or Taxotere may sometimes be added.

CMF, which combines the medicines Cytoxan, methotrexate, and 5-FU.

Treatment of breast cancer can cause nausea and vomiting. Medicines to control and prevent nausea and vomiting may include: Serotonin antagonists, such as ondansetron (Zofran), granisetron (Kytril), palonosetron (Aloxi), or dolasetron (Anzemet). These medicines work by blocking the effects of a chemical that affects vomiting (serotonin), which is made in the brain and in the stomach. They are often more effective when they are combined with aprepitant and/or corticosteroids, such as dexamethasone. Corticosteroids reduce swelling in the part of the brain that controls nausea.

Aprepitant (Emend), which prevents and controls nausea and vomiting by blocking the effects of a chemical in the brain. It is always used in combination with a serotonin antagonist and/or dexamethasone.

Phenothiazines, such as Compazine and Phenergan. These medicines stop nausea and vomiting by reducing the activity of the central nervous system.

Metoclopramide (Reglan), which increases the movements or contractions of the stomach and intestines. This decreases the amount of time it takes for the stomach contents to move through the digestive tract.

Dimenhydrinate (Dramamine), which is often used to treat motion sickness. It relieves nausea by blocking motion signals to the brain.

Benzodiazepines, which are medicines to reduce anxiety, such as lorazepam (Ativan) or alprazolam (Xanax). This medicine can help with both anxiety and nausea when used with other anti-nausea medicine.

Hormone-blocking treatments, such as tamoxifen or an aromatase inhibitor, act on cells all over the body but generally cause fewer side effects than chemotherapy. If you are deciding what type of medicine to use, weigh the side effects and risks along with the benefits for your type of cancer.

Neither chemotherapy nor hormone therapy is likely to cure breast cancer that has spread to another area of the body (metastasized), but either therapy can reduce symptoms and may prolong life.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.